病毒性脑炎昏迷患者脑血流动力学变化分析

Changes of cerebral hemodynamics in coma patients with viral encephalitis

目的通过观察病毒性脑炎患者昏迷过程中的脑血流动力学情况,探讨经颅多普勒超声(TCD)的参数与格拉斯哥昏迷评分(GCS)的相关性,发现更好的适时、客观评估病情的TCD参数。方法应用TCD动态观察24例病毒性脑炎昏迷患者入院后第1、3、7天的大脑中动脉血流,同时记录下TCD各参数和GCS评分。结果 PI值与GCS评分呈显著负相关(r=-0.72);24例患者中有4例出现涡流信号,频窗充填,最后全部死亡;昏迷患者发病3 d左右病死率较高,后趋稳定。结论 TCD的PI值比GCS评分能更好的反映出患者的病情,对指导临床治疗有一定帮助;根据连续PI值和频谱检测可以初步了解病情发展趋势、判断预后。

Objective To investigate the relation of GCS and TCD parameters and discover the better TCD parameter which can assess the disease timely and objectively,as well as appraise patient＇s prognosis in the early time,by observing the cerebral hemodynamic situation during the course of viral encephalitis patients with coma,learn the cerebral hemodynamic during the process of unconscious patients.Methods The cerebral blood flow of MCA in 12 cases of viral encephalitis patients admitted to the first day、third day and seventh day was observed dynamicly,the TCD parameters and the GCS score were recorded simultaneously.Results PI value and GCS score was significantly negatively correlated（r=-0.72）,four cases of twenty four have appeared eddy current signal,the frequency window of filling,and finally all died.Patients in coma for about three days a higher mortality rate,the latter stabilized.Conclusion PI value of TCD can reflect the patient＇s condition to guide clinical treatment.According to several consecutive PI values and the spectrum,we can know the initial condition development trends of the disease and predict prognosis.